Antimicrob Agents Chemother:广泛耐药肺结核:氯法齐明获益有限!

2018-08-15 吴星 环球医学

由于耐药结核病的诊断复杂,治疗困难,对个人、家庭及社会均造成巨大的经济压力。2018年3月,发表在《Antimicrob Agents Chemother》的一项多中心、前瞻性、随机研究,旨在调查在中国氯法齐明(CLO)治疗广泛耐药肺结核(XDR-TB)的有效性和安全性。

由于耐药结核病的诊断复杂,治疗困难,对个人、家庭及社会均造成巨大的经济压力。2018年3月,发表在《Antimicrob Agents Chemother》的一项多中心、前瞻性、随机研究,旨在调查在中国氯法齐明(CLO)治疗广泛耐药肺结核(XDR-TB)的有效性和安全性。

49名XDR-TB感染的患者随机分配到对照组或CLO组,两组都接受36个月的个体化定制治疗。首要终点指标为固体培养基检测的痰培养转化的时间。治疗完成时评估患者的临床结局。

试验组的22名患者中,7人(31.8%)满足“治愈”的治疗标准,1人(4.5%)“完成治疗”,总共8人(36.4%)表现为成功治疗结局而不复发。对照组中,6名患者(22.2%)治愈,6人(22.2%)研究结束时完成治疗。统计学分析显示,CLO组和对照组的成功结局率没有显着性差异。试验组痰培养转化的平均时间为19.7个月,与对照组的20.3个月无统计学差异(P=0.57)。CLO组的22名患者中,12人(54.5%)开始CLO治疗后出现不良事件。最常见的不良事件为肝损伤,其中CLO组31.8%(7/22),对照组11.1%(3/27)表现出该不良事件。

该研究证实,在XDR-TB的背景治疗方案中引入CLO的获益有限,尤其是肝损伤的出现为CLO治疗的严重不良事件。

原始出处:

Wang Q, et al. Clofazimine for Treatment of Extensively Drug-Resistant Pulmonary Tuberculosis in China. Antimicrob Agents Chemother. 2018 Mar 27;62(4). pii: e02149-17. doi: 10.1128/AAC.02149-17. Print 2018 Apr.

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    2018-08-26 grace5700
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    2018-09-15 wjywjy
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    2019-06-21 xjy02
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    2018-08-15 lietome2

    好文,值得点赞!认真学习了,把经验应用于实践,为患者解除病痛。

    0

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